ABSTRACT
Background: Literature on the spectrum of opportunistic disease in human immunodeficiency virus (HIV)-infected patients from developing countries is sparse. HIV-related opportunistic infections (OIs) continued to cause morbidity and mortality in HIV-infected individuals. Objectives: The objective for this study was to elucidate the prevalence and spectrums of OIs in HIV- infected patients in the Gandhinagar Civil Hospital. Material and methods: The evaluation of the prevalence and spectrums of OIs was conducted by using the clinical data of 834 HIV-infected patients in the Gandhinagar Civil hospital from November 2012 to December 2013 those who were attended physician OPD for OIs. Results: The prevalence and spectrums of OIs varied contingent on sex, age, CD4 levels and treatment with ART. We found that tuberculosis was most common OI with prevalence being 20.50%, followed by Pneumocystis pneumonia (PCP) (5.16%) mycobacterium avium complex(MAC) (1.80%), candidiasis (1.56%), cytomegalovirus (CMV) infection (0.24%), progressive multifocal leukoencephalopathy (PML) (0.12%). Males (31.85%) were more prone to get OIs than females (27.85%). Pulmonary OI infections were the most prevalent morbidity and mortality in patients in the AIDS stage including pulmonary tuberculosis (7.43%) and PCP (5.16%). Fungal OIs were one of most prevalent morbidity in patients in the AIDS stage, including oral candidiasis (1.79). EPTB (13.07%) was more common than PTB (7.43%). OI in AIDS is more common in 41 to 60 years (32.93%) of age group. OI was more common in patients with CD4 count from 51-100 (86.96%) followed by 101 to 150 (69.05%). OI was more common in patients who were not on ART (72.33%) than those on ART (27.67%). Conclusion: The prevalence and spectrums of OIs, was discussed in this study. It would help to increase the awareness for physicians to make a diagnosis and empirical treatment sooner and plan good management strategies, especially in resource limited regions.
ABSTRACT
Background: In Rheumatic heart disease, mitral valve is most commonly affected. Approximately 25% of all patients with rheumatic heart disease have pure mitral stenosis. 10% of all rheumatic heart disease patients have pure mitral regurgitation and 40% have combined mitral stenosis and mitral regurgitation. This study is the correlation between clinical status and common pulmonary functions in patient with mitral valvular disease and improvement in pulmonary functions after surgery in mitral valvular heart diseases. Aim and objectives: To study the pulmonary function test (PFT) in patients with mitral valvular heart diseases, to study PFT in patients with mitral valvular heart diseases with various age groups, to study clinical features and investigatory profile of mitral valvular heart diseases with various age groups, to study clinical features and investigatory profile of mitral valvular heart disease patients, to study study PFT in various stages of mitral stenosis and mitral regurgitation, to compare the pulmonary function test results before and after treatment of mitral stenosis (MS) and mitral regurgitation (MR). Material and methods: This present study was carried out of total fifty patients of mitral valve disease to determine the changes in Spirometric pulmonary function. Out of this, forty patients were of mitral stenosis and ten patients were of mitral regurgitation. These patients were selected from indoor as well as outdoor cases of Civil Hospital, Ahmedabad and U. N. Mehta Cardiology Institute, Ahmedabad. The diagnosis was made by clinical features , X-ray , electrocardiography and echocardiography studies and all patients, selected for study, were underwent operative procedure. Results: Mean age of cases in this study was 30.46 years. So that present study showed that younger age groups were more affected in rheumatic mitral stenosis and regurgitation. Present study showed that mean value of FEV1/FVC% was 84.69 % in NYHA class II, 88.49% in NYHA class III and 81.51% in NYHA class. Present study showed that mean value of FEV1/FVC% of all classes were 86.06% preoperatively and after operation 89.94%. Present study showed that mean value of FEF 25- 75% was 2.47 liter/sec preoperatively and after operation 2.81 liter/sec. Conclusion: In all cases of mitral valve disease, pulmonary function tests abnormality predominantly reveals restrictive pattern of lungs.